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SAN JOAQUIN COUNTY <br />cNVIRONMENTAL HEALTH DEPARTMENT( <br />600 East Main Street, Stockton, California 95202-3029 <br />Telephone: (209) 468-3420 Fax. (209) 468-3433 Web: www.siaov.org/ohd <br />UNDERGROUND STORAGE TANK Il1ST1 PROGRAM INRIP=cTIAKI OPOCIDT <br />Facility name: <br />Sae, <br />f Vl�fit -�.� lD,� <br />lX f M!L <br />K �AJvvlin�fmv <br />Ip�e,,s�eated Opamt_ or: kj <br />oat - Inspection <br />D/ <br />�/ 7( <br />Facility ddress: <br />pa�t�,z ��, she-hA <br />U T# �- <br />.-Product <br />Facility Contact: <br />pwrw <br />Title: Phone: <br />clerk 4-121 B`6ex (24 <br />Monitoring Panel: <br />Piping system: <br />Pressurized ❑ Suction ❑ Gravity <br />Overfill prevention: <br />❑ Mechanical Audible/visua <br />I <br />acUQ� type' <br />outirSl3"� 9 Monitorin Certlflcation ❑ Installation ❑ Other. <br />Violations: <br />Mi-RDetect ❑ M2-RPrev ❑ M-3 Bath <br /># <br />Code Section <br />VIOLATION(S) HSC=Califomia Health & Safety Code; CCR=California Code of Regulations V R <br />V=Violation; RV=Re eat Violation . V <br />1 <br />HSC 25284 <br />Permit too erate <br />2 <br />CCR 2637 <br />Seconds containment test performed <br />3 <br />CCR 2711 b & c Current Unified Pro ram Consolidated Forms on file with EHD(Facility and tank form <br />4 <br />HSC 25292.2 <br />Certification of financial responsibility and CFO letter <br />5 <br />CCR 2632 <br />Monitoring Program Monitori & Response Plan is current and approved b the focal ency. <br />6 <br />CCR 2712 t <br />Monitoring Ian is onsite. <br />7 <br />CCR 2712 b <br />Maintenance &monitorin records M1 <br />8 <br />CCR 2643 d <br />Daily monitoring of suction pip! r"anua 1, 1984 <br />9 <br />HSC 25292.1 <br />UST system Is operated to prevent unauthorized release <br />10 <br />CCR 2632 (c)(2) <br />UST monitoring system is present M1) <br />11 <br />CCR 2630 d <br />UST system monitoring equipment is ro I located to detect a leak M1 <br />12 <br />HSC 25291 b <br />UST system monitorin equipment is c eretional (M1 <br />13 <br />CCR 2638 1 <br />Continuous momborin system for undo mund ipin &UDC is resent M1 <br />14 <br />CCR 2631 a <br />Prima containment isproduct tight <br />15 <br />HSC 25291 (a)(2) <br />Secondary containment for UST is tight <br />16 <br />CCR 2636 (c)(1) <br />All releases in secondary pipingflow to a collection sum <br />17 <br />HSC 25291 <br />Line leak detector(s) are Installed M1 <br />18 <br />CCR 2635 (b)(1) <br />Spill container - M2) <br />19 <br />1 CCR 26.35 (b)(2) <br />Ovefll prevention system M2 <br />20 <br />CCR 2636 (a) <br />Conventional suction piping shall have continuous monitoring & 20 containment <br />21 <br />HSC 25291 (e) <br />Water in 2° containment analyzed <br />& ro ed disposed of. <br />22 <br />CCR 2650 <br />Racordin /re odi - of.unauthorized <br />releases (MI) <br />23 <br />CCR 2715 <br />Desi nates O eretor. a Statement from UST owner; (c -e) Monthly Inspection; M Employee traininq <br />24 <br />CCR 2638 a <br />Annual monitorin certification <br />25 <br />CCR 2638 a <br />Annual line leak detector testM1 ) 15el <br />26 <br />HSC 25284.2 <br />Annuals ill containment testin <br />27 <br />CCR 2636 4 <br />Annual line ti htness test M1 <br />28 <br />CCR 2667 <br />Repair for tank/piping has had ti htness test (M2 <br />29 <br />CCR 2643 a <br />Biennial ti htness test of revs i in re -Jana 1, 1984 <br />30 <br />CCR 2643 d <br />Triennial line test for conventional suction piping (pre-January1, 1984 M1 <br />31 <br />HSC 25292.5 <br />Double wall system located within 1000' of public well-ELD <br />32 <br />CCR 2661 <br />Permit to repair UST system <br />33 <br />HSC 25288 a <br />Permit to alter monitorin s tem <br />34 <br />HSC 25298 <br />Permit to tem orarif close UST s stem <br />35 <br />HSC 25298 c <br />Permit to close UST system <br />36 <br />HSC 25299 <br />(awgww <br />Disabling leak detection devices <br />37 <br />HS 298 a <br />Ille al abandonment of UST systom <br />38 <br />EHD INSPECTOR: <br />PHONE: <br />TO / O t7 <br />- UIC <br />Seetic�tem, <br />D Serves � peoplelday <br />D Receives other than sanitary waste <br />Qlbw disposal methods: <br />D D wells/Franch Dralm <br />RECENED BY: <br />TIT E: <br />Jel CV�� <br />EHD 23-02-002 REV =6 <br />